The Program for the Elimination of Cancer Disparities (PECaD) at the Alvin J. Siteman Cancer Center, St Louis, MO of Washington University School of Medicine and Barnes-Jewish Hospital was established in 2003 with institutional funds in response to known excess cancer burden within the region particularly for minority and medically underserved populations. The Goals are to create a national model for eliminating disparities In cancer through community-based partnerships and community based participatory research (CBPR);to increase access by breaking down barriers to quality cancer care;and to be a catalyst for change in our region by fostering healthy communities. Given the fractured history of St Louis and its segregation, PECaD has worked with numerous community organizations and provider groups to build trust and has harnessed resources from non federal sources and NCI. We now propose to further strengthen partnerships in the St. Louis region and extend our activities to additional areas chosen based on poverty levels;limited access to cancer screening and prevention services;excess cancer incidence or mortality;and expressed community Interest In collaborative efforts to address cancer health disparities. Our three communities are St Louis City and North County, MO;St. Clair County, IL, and southeastern Missouri. The Specific aims are: 1. In collaboration with our community partners, using the community outreach program and working with our community partnerships, we will extend and evaluate the effectiveness of outreach. 2. In a research project created in partnership with our colorectal cancer community partnership, we will design and conduct a RCT of community awareness plus systems level changes to reinforce provider behavior change to order and follow-up on colorectal cancer screening tests. 3. In our pilot educational research project created with our prostate cancer community partnership, we will evaluate barriers and facilitators to participation in prostate CA tissue collection for research (biobanking). 4. Through our training program, provide CBPR training for researchers and community members collaborating with the program and institute an ongoing process for Identifying and vetting future pilot projects. 5. In conjunction with our community Disparities Elimination Advisory Committee (DEAC), we will develop a framework for evaluation within and across our Community Outreach, Research, and Training Programs.